Current Medical Consensus
For decades, women were advised to take hormone therapy to avoid the discomforts of menopause and be protected against many chronic diseases common in the post-menopause years. In addition to decreasing hot flashes and other signs of menopause, replacing the natural hormones lost in menopause was thought to be a good way of protecting women against heart disease, osteoporosis, memory loss, wrinkles, and mood swings. To gain these assumed benefits, women were advised to begin taking hormones before menopause, and to continue taking them for many years, or even decades post-menopause, in order to have the best quality of life and avoid serious illness.
Doctors usually prescribed a combination of synthetic estrogen and progestin to replace falling levels of the two hormones, a natural condition of menopause. Women who had a hysterectomy only needed to take estrogen. The latest studies, which are considered definitive, have clearly shown that the risks of taking these hormones far outweigh the benefits. Women taking Prempro, the combination hormone pill used in the aborted clinical trials, were far more likely to develop breast cancer, stroke, blood clots, and Alzheimer’s, and just as likely to develop heart attacks, compared to women taking a placebo. Women taking estrogen alone (Premarin), had increased risks of blood clots and stroke.
The first shift in thinking about hormone therapy was a name change. Hormone replacement therapy was changed to hormone therapy to underscore that hormones don’t necessarily need to be replaced in menopause. Doctors now tend to prescribe hormones only in cases of severe menopause
symptoms, when discomforts interfere with the quality of life.
New Guidelines from the FDA
The FDA has issued guidelines to advise physicians and drug companies with regard to patient education. If the guidance you received differs from this, you should contact your physician to discuss these recommendations and question whether you should change anything you are doing, including stopping taking Prempro or other hormone therapy for menopause.
Listed below are the new FDA recommendations:
- Hormone therapy is effective for short-term relief of moderate to severe menopausal symptoms such as hot flashes;
- Hormone therapy can be effective for moderate to severe vulvar and vaginal atrophy, but topical agents should be tried first;
- Hormone therapy is effective for reducing the risk of osteoporosis, but it should only be considered for women at major risk for osteoporosis who can’t take other medications to prevent osteoporosis.
- Hormone therapy should only be taken at the lowest possible dose and for the shortest possible time to achieve a therapeutic benefit.
The Bottom Line
Hormone therapy is not a miracle drug to restore your youth, protect your health, and stave off the diseases of old age. In fact, it can have the opposite effect and stack the deck so you are more likely to experience breast cancer, stroke, Alzheimer’s disease, dementia and blood clots. It does have some limited benefits for treating short-term symptoms of menopause such as hot flashes and insomnia. If you have symptoms of menopause which you find hard to live with, discuss options with your physician. Even small amounts of hormones have powerful effects on the body. Take them with caution, if at all.
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